What's New in MRI of Peripheral Nerve Entrapment?

Hof, Jurrit J.; Kliot, Michel; Slimp, Jefferson C.; Haynor, David R.

doi:10.1016/j.nec.2008.07.005

Cited by 46 publications

(15 citation statements)

References 34 publications

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“…Múltiples axones forman un fascículo que, a su vez, está recubierto por un estroma fibroso, el perineuro. Varios fascículos forman el nervio, que está recubierto por el epineuro, que es una capa de tejido conectivo que contiene los vasos sanguíneos que irrigan al nervio (18) (Figura 1). …”

Section: Anatomía Del Nerviounclassified

Neurografía por resonancia magnética en la evaluación de los nervios periféricos

Cejas

2015

Rev. chil. radiol.

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IntroducciónLa neurografía por resonancia magnética (NRM) es el método por imágenes que permite el estudio de los nervios periféricos a través del empleo de secuencias dedicadas, de alta resolución. El término neurografía (Neurography) fue introducido por Chhabra en el año 2011(1) y en años posteriores surgieron numerosos trabajos avalando esta técnica (2)(3)(4)(5)(6) . Para interpretar la NRM es necesario contar con conocimientos generales de RM, así como de la anatomía y de las lesiones que afectan al sistema neuromuscular. La patología de los nervios y plexos puede dividirse en mononeuropatías y polineuropatías. En las mononeuropatías se encuentran causas como los procesos inflamatorios, el trauma, el atrapamiento, los tumores benignos y malignos de la vaina neural, así como aquellos tumores de estructuras adyacentes que pueden comprimir o invadir al nervio/plexo (7)(8)(9) . En las polineuropatías se destacan las formas hereditarias como la enfermedad de Charcot Marie Tooth y las adquiridas, entre las que se encuentran la poliradiculoneuropatía desmielinizante idiopática crónica, diabetes, vasculitis, inflamación (10)(11)(12) . El objetivo de esta revisión es explicar las consideraciones técnicas sobre la NRM, mencionar las características normales del nervio periférico por NRM y describir la apariencia de las lesiones más frecuentes que afectan a los nervios y plexos. Magnetic resonance neurography in the evaluation of peripheral nerves Abstract: Magnetic resonance neurography (MRN), with high resolution sequences, allows for a detailed study of the plexus and peripheral nerves. For its interpretation, it is necessary to have a general knowledge of MR, as well as of the anatomy of the neuromuscular system and lesions that affect it. Nerve and plexus pathology can be divided into mononeuropathies (for trauma, entrapment or tumors) and hereditary polyneuropathies (such as Charcot-Marie-Tooth disease) or acquired (for chronic idiopathic demyelinating polyradiculoneuropathy, diabetes, vasculitis or inflammation). The objective of this review is to describe the study technique of Magnetic Resonance Neurography as well as the characteristics of the normal and pathological peripheral nerve. Keywords: MRI, MR Neurography, Peripheral nervous system, Peripheral neuropathy. Resumen: La neurografía por resonancia magnética (NRM), con secuencias de alta resolución

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Section: Anatomía Del Nerviounclassified

Neurografía por resonancia magnética en la evaluación de los nervios periféricos

Cejas

2015

Rev. chil. radiol.

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“…Normal peripheral nerves appear isointense compared to muscle, surrounded by a small rim of fat tissue. An entrapped nerve generally shows increased signal on T2-weighted and STIR images over the abnormal segment (Hof et al, 2008;Stoll et al, 2009;Thawait et al, 2011; The signal changes of injured nerves on T2-weighted and STIR images may reflect changes in water content due to altered axoplasmic flow, endoneurial or perineurial edema as a result of changes in the blood-nerve barrier or axonal myelin degeneration (Filler et al, 1996).…”

Section: Basics Of Peripheral Nerve Imagingmentioning

confidence: 99%

Role of Skeletal Muscle MRI inPeripheral Nerve Disorders

Matsuda¹,

Kobayashi²,

Ugawa³

2012

Peripheral Neuropathy - Advances in Diagnostic and Therapeutic Approaches

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“…It is still under-recognized by clinicians and misdiagnosis or delay in treatment can occur as a consequence. Magnetic resonance (MR) imaging studies have been attempted for diagnosis of brachial plexus disorders [6][7][8][9]. However, there are very few reports about MR neurography for zoster-induced brachial neuritis [6].…”

Section: Dear Sirsmentioning

confidence: 99%

“…Inflammatory changes in the brachial plexus result in swelling and thickening of divisions or cords of the brachial plexus. MRI can demonstrate inflammatory changes in neural tissue and MR neurography can detect inflammatory changes in the brachial plexus and denervation edema of affected muscle [6][7][8][9]. Especially STIR images from MR neurography have been used for evaluation of pathological lesions of the brachial plexus such as neuralgic amyotrophy [7,8].…”

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Magnetic resonance neurography findings in herpetic brachial plexopathy

2010

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Dear Sirs,Brachial plexus neuritis was originally diagnosed by clinical signs and symptoms in addition to electrophysiological studies [1][2][3][4][5]. Therefore, initially, brachial plexopathy was misdiagnosed as a shoulder disorder, cervical radiculopathy, or myelopathy [4]. Herpes zoster brachioplexopathy is a rare complication characterized by motor weakness of the arm, which may occur in limbs affected by herpes zoster. Varicella zoster virus can induce inflammatory brachial plexopathy [1][2][3][4]6]. It is still under-recognized by clinicians and misdiagnosis or delay in treatment can occur as a consequence. Magnetic resonance (MR) imaging studies have been attempted for diagnosis of brachial plexus disorders [6-9]. However, there are very few reports about MR neurography for zoster-induced brachial neuritis [6]. We present a 68-yearold male patient with monoparesis resulting from brachial plexopathy caused by varicella zoster virus infection and report the findings of MR neurography in this patient.A 68-year-old man noted a skin rash, vesicles, and pain in his left arm. At that time, he was not treated. Four days later, he developed weakness in his left arm and visited the emergency department at our hospital for this complaint. Upon admission, the patient had multiple erythematous crusted plaques on the left arm (Fig. 1). Neurologic examination revealed weakness of shoulder abduction (grade 2/5) and elbow flexion (grade 2/5), and the left biceps reflex was diminished. He had dysesthesia and hyperalgesia over the left C6-7 dermatomes. The level of IgG antibodies against varicella zoster virus was elevated. However, the IgM antibody level against varicella zoster was negative. We performed MR neurography of the brachial plexus with a 1.5-T MR imaging system (Gyroscan Intera, Philips Medical Systems, Netherlands) 10 days after admission. Among the MR neurography images, the coronal short tau inversion recovery (STIR, TR/TE: 3558.39/60.00, time inversion: 160 ms) image depicted edema and thickening of the superior trunk of the left brachial plexus compared to the unaffected right side (Fig. 2). MR imaging also showed denervation edema of the left supraspinatus muscle (Fig. 3). Needle electromyography showed fibrillations and positive sharp waves in the left deltoid and biceps muscles and only positive sharp waves in the left supraspinatus muscle. The patient was treated with intravenous acyclovir and physical therapy for his left arm. After discharge, he was followed in the outpatient department for 6 months. His left-arm weakness improved to grade 3.Herpes zoster brachial plexus neuritis-associated motor weakness may be due to a demyelinating process related to inflammation [1-3, 5, 6]. Inflammatory changes in the brachial plexus result in swelling and thickening of divisions or cords of the brachial plexus. MRI can demonstrate inflammatory changes in neural tissue and MR neurography can detect inflammatory changes in the brachial plexus and denervation edema of affected muscle [6][7][8][9]. Especially STIR ...

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What's New in MRI of Peripheral Nerve Entrapment?

Cited by 46 publications

References 34 publications

Neurografía por resonancia magnética en la evaluación de los nervios periféricos

Neurografía por resonancia magnética en la evaluación de los nervios periféricos

Role of Skeletal Muscle MRI inPeripheral Nerve Disorders

Magnetic resonance neurography findings in herpetic brachial plexopathy

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